Tuesday, November 26, 2013

C-Sections and Recovery: 2 Weeks Out

I had my 2 week check-up today with my OB. It's amazing that we only met Cora two weeks ago- she's so loved and such an elemental part of our life and routine already, and the hospital portion of it all seems so far away. But two weeks ago it was! Everything went great- I'm 10 lbs. off my pre-pregnancy weight (maybe a little extra fluid still, but probably mostly extra cookies), my incision looks great, and the check-in nurse verified twice that it wasn't my 6 week check-up. While I was at the OB, JP took Cora across the street for her 2-week newborn screening. I left my doctor in a great mood, but Cora is still pissed about the heel prick. She's frowning in her sleep on JP's chest right now and I think she's having flashbacks.

pre-heel prick; braced for the arctic DFW temps

One of my closest co-workers is pregnant with her first child and was asking me and our other co-worker friend about our experiences with delivery and recovery. I've written each kid's birth story: Landon's (vaginal) is here (recovery post here); Claire's (scheduled c-section due to birth trauma to a preemie Landon from my narrow pelvis) is here (2 weeks out post here); and Cora's (also scheduled c-section) is here. I felt like each was a really good experience. Landon's delivery went very well (for me). While I feel confident that a c-section was the right way for me to go post-Landon, that was to protect the baby, not because I didn't want another vaginal delivery. I'm glad I got to have that experience- the length of it, the intimacy, the feeling of JP and I being in it together in our darkened room overnight, waiting for the contractions to get stronger and our son to be born. A c-section, while still both good experiences for me, is definitely more clinical. It's so quick, in a bright sterile room, and you're physically totally cut off from what's happening below your chest. If the anesthesiologist hadn't told me Cora was about to be born, I would have had no idea. It's fine- c-sections serve an important purpose, and JP (and this time my mom too!) was still right there with me, but it's all a bit surreal. Lay down, go numb, here's your baby! I never gave a lot of thought to how my babies would be born while I was pregnant- it seemed largely out of my control and useless to worry over, and then Landon arrived a month before I might have started to worry about it despite myself, so I didn't have much emotional attachment to one method over the other. While I would have opted for another vaginal delivery after Landon, I didn't mind when it was clear afterward that it would be better that future babies be born by c-section. The c-sections were good experiences too, just very different ones.

As for recovery- at two weeks out, I've found the recovery to be exactly the same. I'm me- I've been off any pain pills for a week, I can move, bend, and generally live the way I normally do. I'm in normal clothes (leggings and a sweater dress- I'm loving fall postpartum), and I feel great. My scar is a little numb, but it's thin and pale and there's no pain or itching or anything else. I still can't exercise, have sex, or lift anything "too heavy" (left to my discretion to decide what that is... Cora and her car seat are not, Claire probably is), but all those restrictions are similar to a vaginal delivery and will go away in another month. The difference for me was the early days- I felt good pretty much immediately after Landon's vaginal delivery, while the c-section sends you a bit deeper down the recovery valley at first. You've had abdominal surgery, the gas pain is worse than the incision pain, you need help getting out of bed- transitioning from sitting to standing is hard and a bit overwhelming, and the nurse's directive to start walking within 24 hours of surgery seems even more so. But I knew from Claire, and I learned again with Cora, everything gets better if you get up and move around. At least once you have the right pain medicine. Once I got off the hydrocodone and on Percocet about 24 hours after surgery, I was back up the upward trajectory (insider tip: you should not feel awful after your epidural or IV is taken out, pain pills can be very effective- if you're dizzy, faint, and in extreme pain when you try to stand up, you're on the wrong medicine; I don't think I would have realized that if I hadn't remembered how much better I felt after having Claire). With the pain pill thing settled, I went home pretty much exactly 48 hours after surgery and felt really good. I moved around slowly and got out of bed and out of chairs even slower (and JP had to help me put on socks, I remember that because my feet were freezing until I tracked him down in the kitchen to do it our first morning home), but I didn't hurt. I could hold and care for Cora, as long as someone was around to pass her to when I needed to transition from standing up or sitting down. That's another thing with a c-section- you're going to need more help. Or even if you don't need it, asking for and using any help offered will help your recovery immensely. I found the recovery slope to rise swiftly- each day was a huge improvement from the one before. My parents left 4 days after Cora was born and while that seemed too soon on day 2 and even day 3 post-surgery, it turned out to be fine. By day 5 I was moving around well (clearly, I ran 3 errands and went out to lunch with my mom that morning) and of course, I still had JP (who was particularly helpful in doing 100% of the care for the bigger children and holding Cora and my hand every time I needed to get out of a chair). Also, coughing, sneezing, or laughing for the first 10 days or so after a c-section is terrifying (sort of like going to the bathroom after a vaginal delivery), but rest assured, none of those things will actually cause your stitches to burst. So, deeper valley (not that vaginal delivery recovery wasn't still a valley; I remember wincing every time I sat down, so kind of the opposite of the post-c-section slow transition to standing up, but other than some tenderness, the way I felt 48 hours post-Landon probably took me 7 or so days to reach post-Claire or Cora), but noticeable improvement every day.

One other thing my co-worker asked about was packing for the hospital. With Landon's surprise birth, I only had what was in my purse and the few electronic items (camera!) I sent JP home to fetch after my water broke downtown. With Claire, I got to plan, but wasn't sure what I'd want to wear post-c-section. So with Cora, I should have been all set, but I couldn't really remember what I felt like immediately post-Claire (thus the memorializing of this post, not that it will help me again) and still wasn't sure what to pack so I threw a bunch of things in a bag to figure out there. Here's what worked for me:

A small bag (we used a backpack) with camera, phone chargers, chap stick, and JP's Economist magazines for him to bring in to the hospital for the surgery, and then a larger bag for all the clothes and toiletries to stay in the car until we were in our real room. In the bigger bag:
- fuzzy socks: preferably with grippers, or a pair of slippers; as mentioned above, you'll be walking around as part of your recovery
- nursing tanks: I like the $15 ones from Target, but there's a whole array of fancier ones to choose from too. I liked wearing these in lieu of a bra because they're soft and comfortable, provided some support for my tummy, and I liked the coverage when unsnapping my gown or sleep shirt to nurse or have my incision checked. Even if I had no intention of breastfeeding, I'd want a few tanks in my bag
- wrap top open sweater, or other cozy thing that is easy to take off and on when cold while sitting
- loose pants: I didn't even wear pants until day 2- the blankets in bed covered my legs just fine and I wore my hospital gown on my first walk (a robe might be nice, but I only own a giant bright red terry cloth one and that was decidedly not coming to the hospital). For pants, I found a lower waist band that was fairly loose and just rested on my bandaging worked well- at first, a higher waist seemed like the answer, but I found with Claire that I didn't like anything pressing on my stomach, and the incision area was actually too numb to be tender, so it worked best for me to have something that lightly rested right about there.
- PJ set: this was a gift to myself this time around and I loved it- loose pants, a nursing tank, and a short robe-like wrap top- perfect to wear while sitting. I got my set from Motherhood (like this, but my set was navy blue and I got another one that was light grey with a polka dotted tank). This is basically all I wore in the hospital and it's what I ended up wearing home too
- chap stick!: my lips get so dry in the hospital, this was the first thing I asked JP to dig out of the backpack and put on my hospital tray table
- face wipes : I loved having these for the first night when I wasn't ready to take a shower but wanted to feel like I did)
- toiletries: toothbrush, toothpaste, lotion, etc. basically whatever you'd pack for a weekend away (and everyone is different, but I loved having my blow dryer, straightener, light makeup etc.- maybe you won't want to mess with it, but I did and it made me feel 300% more human to do so)
- baby clothes: maybe the most important thing, if your baby isn't in the NICU, you get to change their clothes! (We didn't know that until we had Claire.)
- electronics: I loved having my laptop with me, it connected me to the outside world on my own terms (sharing pictures, sending emails, etc.) and I loved being able to go through my pictures right away. I brought my kindle but never touched it- we were in the hospital for such a short amount of time that pictures and a few blog posts were as much entertainment as I needed. You'll also want all your chargers, etc.
- snacks: I've had friends say they were starving right after having a baby. I wasn't with any of the three- actually, my appetite pretty much disappeared for 48 hours with each, but if we'd had snacks, it might have been nice to give the kids when they came to visit after school (they ate my jello instead). Oh, and with Cora they had me on a "light/mostly liquids" diet for the first 12 hours or so. They didn't do that with Claire, but it didn't really matter since I wasn't hungry anyway (just an FYI for other people who might want to smuggle in some crackers or something).

That's about it- really, it's just a weekend away. I never bothered with my own pillow or blankets (or underwear- embrace the mesh!), but if you're in the hospital for 3-5 days as you could be for a c-section, you may want them. This time around I basically wore the matching PJ set (top only for day 1, different top with pants on day 2, and then we were home), fuzzy socks, and chap stick. I played with my camera and laptop and held Cora. It was a pretty brief stay.

That's all I can think of on c-sections. Before I had Cora I went back and read all my June 2010 archives to try to remember what my recovery was like with Claire, but all I remembered was the wonder and joy of Claire and I worried I was glossing over the actual experience. But here I am 2 weeks out with Cora and I'm already mostly only remembering the wonder and joy of Cora. I do very clearly remember taking that first walk on the hydrocodone and feeling like I was going to faint and the ONLY things keeping me upright were my death grip on JP's arm and the knowledge that falling down and being caught by him would hurt my abdomen so badly that I refused to do it. But that was due to bad pain medicine, not the c-section, so I'm not sure it's fair to focus on. I took a walk 3 hours later on Percocet and made a whole loop around the nursery and nurse's station (slooooowly, but not painfully). Pain control is everything- take the drugs, beep your nurse for your next pill 5-10 minutes before you're due for it, and ask every nurse you have for advice on controlling the gas pains (it's hard to describe the gas pain if you haven't had abdominal surgery, it was far more pressing than anything from the incision and it can hurt all the way from the tips of your shoulder blades on down; it is bizarre and as important to control as any other pain). Each nurse had a different suggestion and I found them all helpful (a combo of milk of magnesia and Maalox was particularly helpful the second night).

Cora's birth is probably my happiest birth experience- it was the most clinical (for whatever reason the OR in Austin seemed warmer), but I got to have Cora on me, skin-to-skin, moments after she was born and she stayed there, cozied up on me for hours afterward. I have a hard time putting what that meant to me into words, to have here there, feeling her breathing up and down on my chest, and being able to look at her tiny face, but it was purely and incandescently wonderful. I couldn't stop smiling. I can't stop when I think about it now- it didn't matter that I didn't know the OB, that I was in a sterile OR, or that my body was being stitched back together a few inches south of Cora's warm body. My baby was with me and everything was wonderful. Vaginal or cesarean was irrelevant- that was the experience I wanted to have and I'm so thankful I finally got to have it the third time around.

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